The Clinical Observation On The Addition Of Tonifying Kidney And Strengthening Yang Traditional Chinese Medicine In The Follicular Phase In The Treatment Of Ovulatory Disorder Infertility

Objective:Observe the clinical efficacy and mechanism of supplementing tonifying kidney and strengthening Yang medicine in the middle and late follicular phase of ovulatory disorder patients,and explore a new idea for promoting the follicular development in Chinese medicine.Methods:A total of 51 cases of infertility patients due to ovulatory disorder in the Reproductive Medicine Department of Jiangsu Province Hospital of Traditional Chinese Medicine were selected from March 2017 to March 2018.The patients were randomly divided into two groups,both of which were treated by the combined treatments of traditional Chinese and Western medicine including CC and Gn and Ziyin Recipe.The distinction between the experimental group and the control group is the addition of tonifying kidney and strengthening Yang medicine in the middle and late of follicular phase in the experimental group.The differences in ovulation rate,LUFS rate,superior follicle quality,follicle development rate,clinical pregnancy rate,early abortion rate,TCM symptom scores and TCM therapeutic index as well as Western medicine clinical efficacy were observed.Results:Follicular development:The dosage of Gn and the time of follicular development were significantly lower in the experimental group(P<0.01).The rate of follicular development and the E2 level of single dominant follicle on the trigger day were significantly higher than the control group(the former P<0.05,the latter P<0.01).And the rate of follicular development increased in both groups after treatment(P<0.01).Periodic outcome:In experiment group,the ovulation rate was 79.4%and the LUFS rate 14.7%and the uninitiated cycle rate 5.9%while in control group was 59.3%,30.5%and 10.2%accordingly.The ovulation rate and LUFS rate were significant different between two groups(P<0.05)while the uninitiated cycle rate was not(P>0.05).Clinical outcome:In experimental group,clinical pregnancy rate was 46.2%and the early abortion rate was 8.3%.In control group clinical pregnancy rate was 26.1%and early abortion rate was 33.3%.They all have no significant difference(P>0.05).The outcome of Chinese and Western medicine:The scores of TCM symptoms in both groups were lower than before(P<0.01).Comparison between the two groups showed the scores of TCM symptoms,the TCM therapeutic index and the clinical curative efficacy after treatment were not statistically significant(P>0.05).Conclusion:Supplementing tonifying kidney and strengthening Yang medicine in the middle and late follicular phase can improve the rate of follicular development,shorten follicular phase,reduce the dosage of Gn,improve follicular quality,increase ovulation rate and pregnancy rate and also reduce LUFS rate.In conclusion,tonifying Yang and nourishing Yin in follicular phase have impacts on regulating the balance of Yin and Yang in body,improving the outcome of follicular development.